Lifestyle advice to cancer survivors: a qualitative study on the perspectives of health professionals

Objectives: Adoption of healthy lifestyle behaviours has shown promising effectiveness in reducing the high morbidity burden of cancer survivors. Health professionals (HPs) are well suited to provide lifestyle advice but few survivors report receiving guidance from them. This study aimed to explore HPs’ perspective of lifestyle advice (on healthy eating, physical activity, smoking, and alcohol) for cancer survivors. Design: In-depth semistructured qualitative interviews were conducted by telephone or face to face. Data were analysed using qualitative content analysis. Setting and participants: Twenty-one UK HPs working in secondary care with breast, prostate or colorectal cancer survivors were interviewed. Results: The overarching theme was that HPs’ desire to provide lifestyle advice was not necessarily matched by knowledge and action. Three main themes were identified: (1) survivorship-centred barriers to provision, (2) HP-centred barriers to provision, and (3) optimal delivery of lifestyle advice. Results suggested that HPs’ perceptions of survivors’ current status of practising health behaviours, their perceived socioeconomic barriers and ability to practise health behaviours, and HPs’ fear for potential loss of connection with the patient influenced provision of lifestyle advice. Further factors included HPs’ knowledge of healthy lifestyle guidelines, feeling that they were not the ‘right person’ to provide advice, and lack of time and resources. HPs stressed that the optimal delivery of lifestyle advice should (1) be tailored to the individual and delivered throughout the cancer journey, (2) be focused on small and achievable changes framed as part of their treatment regimen and (3) be cost-effective for wide-scale implementation. Conclusions: Incorporation of the identified barriers when developing HP training programmes and lifestyle interventions could increase the probability of successful behavioural change, and thus improve outcomes for cancer survivors